Abstract：
BACKGROUND: People with symptomatic hypermobility have altered proprioception however, the origin of this is unclear and needs further investigation to target rehabilitation appropriately. The objective of this investigation was to explore the corticospinal and reflex control of quadriceps and see if it differed between three groups of people: those who have symptomatic hypermobility, asymptomatic hypermobility and normal flexibility.
METHODS: Using Transcranial Magnetic Stimulation (TMS) and electrical stimulation of peripheral nerves, motor evoked potentials (MEPs) and Hoffman (H) reflexes of quadriceps were evoked in the three groups of people. The threshold and latency of MEPs and the slope of the input-output curves and the amplitude of MEPs and H reflexes were compared across the groups.
RESULTS: The slope of the input-output curve created from MEPs as a result of TMS was steeper in people with symptomatic hypermobility when compared to asymptomatic and normally flexible people (p = 0.04). There were no other differences between the groups.
CONCLUSIONS: Corticospinal excitability and the excitability at the motoneurone pool are not likely candidates for the origin of proprioceptive loss in people with symptomatic hypermobility. This is discussed in the light of other work to suggest the receptor sitting in hypermobile connective tissue is a likely candidate. This suggests that treatment aimed at improving receptor responsiveness through increasing muscle tone, may be an effective rehabilitation strategy.
METHODS: Using Transcranial Magnetic Stimulation (TMS) and electrical stimulation of peripheral nerves, motor evoked potentials (MEPs) and Hoffman (H) reflexes of quadriceps were evoked in the three groups of people. The threshold and latency of MEPs and the slope of the input-output curves and the amplitude of MEPs and H reflexes were compared across the groups.
RESULTS: The slope of the input-output curve created from MEPs as a result of TMS was steeper in people with symptomatic hypermobility when compared to asymptomatic and normally flexible people (p = 0.04). There were no other differences between the groups.
CONCLUSIONS: Corticospinal excitability and the excitability at the motoneurone pool are not likely candidates for the origin of proprioceptive loss in people with symptomatic hypermobility. This is discussed in the light of other work to suggest the receptor sitting in hypermobile connective tissue is a likely candidate. This suggests that treatment aimed at improving receptor responsiveness through increasing muscle tone, may be an effective rehabilitation strategy.
摘要：
背景：有症状的过度活动的人已经改变了本体感受，原因尚不清楚，需要进一步调查以适当地康复。这项调查的目的是探索股四头肌的皮质脊髓和反射控制，看看三组人之间是否存在差异：有症状的活动过度者，无症状的过度活动和正常的灵活性。
方法：使用经颅磁刺激（TMS）和外周神经电刺激，在三组人群中诱发四头肌的运动诱发电位（MEPs）和霍夫曼（H）反射。各组比较了MEP的阈值和潜伏期以及输入输出曲线的斜率以及MEP和H反射的幅度。
结果：与无症状和通常灵活的人相比，由于TMS而由MEP产生的输入输出曲线的斜率在有症状的过度活动的人中更陡（p=0.04）。两组之间没有其他差异。
结论：皮质脊髓兴奋性和运动神经元池内的兴奋性不太可能是有症状的过度活动患者本体感受丧失的原因。根据其他工作进行了讨论，以表明位于活动过度的结缔组织中的受体是可能的候选者。这表明旨在通过增加肌肉张力来改善受体反应性的治疗，可能是一种有效的康复策略。
方法：使用经颅磁刺激（TMS）和外周神经电刺激，在三组人群中诱发四头肌的运动诱发电位（MEPs）和霍夫曼（H）反射。各组比较了MEP的阈值和潜伏期以及输入输出曲线的斜率以及MEP和H反射的幅度。
结果：与无症状和通常灵活的人相比，由于TMS而由MEP产生的输入输出曲线的斜率在有症状的过度活动的人中更陡（p=0.04）。两组之间没有其他差异。
结论：皮质脊髓兴奋性和运动神经元池内的兴奋性不太可能是有症状的过度活动患者本体感受丧失的原因。根据其他工作进行了讨论，以表明位于活动过度的结缔组织中的受体是可能的候选者。这表明旨在通过增加肌肉张力来改善受体反应性的治疗，可能是一种有效的康复策略。
